Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Required-1 year visit focusing on COVID-19 Infection Control Practices. LPA was allowed entry by Staff #1 (S-1) and explained the purpose of today's visit.

This home consists of 3 bedrooms, 2 bathrooms, living room and dinning area. It has a detached garage. All (5) Residents receive case management services provided by Frank D Lanterman Regional Center.

COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility, in all common rooms and hallways.

Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing.

Per caregiver all staff are fully vaccinated.

30 day supply of medication reviewed for (3) residents (Resident #1 through Resident #3)

PPE supplies observed inside the home and more stored inside the garage.

Incontinence supplies observed inside the home and more stored inside the garage.

Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed.

Residents were socially distanced according to local public health guidelines.

Exit interview conducted, a copy of this report and Appeal Rights were provided to caregiver.